Musculoskeletal Conditions and World Health Organisation priorities

In 1976, at the World Health Assembly, the then Director-General of the World Health Organisation Halfdan Mahler said:” Perhaps the most fundamental difficulty in regard to rheumatic diseases is that the problem is insufficiently appreciated and understood. Critical to this lack of appreciation is an information deficit.”

In 2000, a WHO Scientific Group on the Burden of Musculoskeletal Conditions at the Start of the New Millenium met in Geneva. The meeting was opened by Dr. G. Harlem Brundtland, Director-General of the World Health Organisation. At the meeting Dr Brundtland mentioned that although the diseases that kill attract much of the public’s attention, musculoskeletal or rheumatic diseases are the major cause of morbidity throughout the world, having a substantial influence on health and quality of life, and inflicting an enormous burden of cost on health systems.

Most recently, in 2010, the WHO published its Global status report on non-communicable diseases 2010; the report confines itself to four NCD’s with high mortality: cancer, cardio-vascular, diabetes and chronic respiratory, there is scarcely a mention of musculoskeletal conditions, or any other non-communicable disease with low mortality and high morbidity rates.

On 19th – 20th September 2011, the UN held a summit, officially called the 'High-level Meeting of the United Nations General Assembly on the prevention and control of non-communicable diseases' .

The General Assembly, taking its lwead from the WHO, prioritized the same four types of non-communicable disease (NCD):

• cardiovascular diseases [heart or blood vessels (arteries and veins)]
• cancers
• chronic respiratory diseases
• diabetes  

By focussing on the four types of NCD that make the largest contribution to mortality the United Nations is leading national governments into prioritising non-communicable diseases with high mortality rather than on non-communicable diseases with high morbidity but low mortality of which musculoskeletal conditions is a major contributor.

So, a generation on from the statement of Halfdan Mahler, little appears to have changed at the WHO; raising awareness for MSC’s remains a priority. And that makes the work going on in the project most relevant.